(&0lwmMv&<£olX£Qt 


in  tfoe  ®it«  oi  l£ew  IgmU 


REPORT    OF    THE    FACULTY    OF    THE    COLLEGE 

OF    PHYSICIANS   AND    SURGEONS   ON 

A    FOUR-YEARS  COURSE 

IN    MEDICINE 


PRESENTED    AT    THE    MEETING   OF   THE    TRUSTEES 
HELD   FEBRUARY    5TH,   1894. 


in  ifte  ©its  at  How  Uorfc 


President's  Room,  Feb.  5TH,  1894. 
To  the  Trustees: 

I  have  the  pleasure   to  submit   herewith   the  report  of  the 
Special    Committee   on   the    four-years'  Medical  curriculum, 
which  report  was  submitted  to,  and  adopted  by,  the  Faculty 
of    the  College  of  Physicians    and    Surgeons    at    a    special 
meeting  held  January  29th,  1894.     This  report  embodies  as 
concise  a  statement  of  the  four-year  course  and  its   advan- 
tages as  it  is  possible   to  make  at  the    present    time.      The 
approval  of  the  curriculum  as  outlined  therein  is  respectfully 
asked  for,  in  accordance  with  Chapter  III.,  Section  2,  of  the 
Revised  Statutes.     As  the  Trustees  are  already  committed  to 
the  policy  of  a  four-years'  curriculum  in  the  Medical  School, 
and  inasmuch  as  changes,  even  of  detail,  in  the  curriculum 
as  now  submitted,  can  only  be  made  with  very  great  care,  it 
will  facilitate  a  prompt  publication  of  the  details  of  the  four- 
year  course,  which  are  now  being  generally  asked  for,  if  the 
Trustees  will  at  this  meeting  pass  a  resolution  approving  the 
course  as  now  outlined.      This  being  done,  any  modifications 
not  affecting  questions  of  policy  will  remain  within  the  power 
of  the  Faculty,  as  heretofore.     A  resolution  to  this   effect  is 
appended.     It    gives    me   pleasure    to  say  that    the  Medical 
Faculty,  without  difference  of  opinion,  so  far  as  I  am  aware, 
believe     that    the    four-year   course    now    presented    is     an 
improvement  on  the  present  curriculum  likely  to  be  worth  all 
that  it   costs  in  its  results  upon   the  education  given  by  the 
College  of  Physicians  and'  Surgeons. 

Respectfully, 

SETH  LOW, 

President. 

Resolved,  That  the  four-years'  course  in  Medicine  as  adopted 
by  the  Faculty  of  the  College  of  Physicians  and    Surgeons 
January  29th,  1894,  be,  and   hereby  is,  approved,  subject  %r 
such  modifications  as  the  Faculty  may  hereafter  make  i- 
the  exercise  of  their  statutory  powers.      (Adopted.) 


Columbia  College  in  the  City  of  New  York. 

College  of  Physicians  and  Surgeons, 

January  29,  1894. 
To  the  Faculty: 

Gentlemen : 

The  committee  on  a  four-years'  course  in  medicine 
begs  leave  to  report  as  follows : — 

It  will  be  remembered  that  in  October,  1891,  at  the  first 
meeting  of  this  Faculty  after  the  merger  with  Columbia 
College,  the  President  of  the  University  stated  that  the 
Trustees  would  entertain  a  proposition  to  establish  a 
required  four-years'  course  in  medicine;  that,  at  the  same 
meeting,  this  Faculty  unanimously  resolved  that  such  a 
course  was  greatly  needed,  asked  for  its  establishment,  and 
appointed  a  committee  to  frame  it;  and  that,  on  June  2,  1893, 
the  President  announced  officially  that  the  four-years'  course 
had  been  established,  and  would  begin  with  the  session  of 
1894-95. 

Two  professors  have  been  added  to  the  original  committee, 
and  the  President  also  has  become  both  a  member  and  the 
chairman  of  the  committee. 

The  first  report  of  this  committee  was  made  at  the  next 
meeting  after  its  appointment.  During  the  sessions  of  1891- 
92,  1892-93,  and  the  present  one,  repeated  reports  have  been 
made  to  the  Faculty,  and  instructions  received  from  it;  the 
views  of  the  several  heads  of  departments  as  to  details  have 
been  gathered;  studies  have  been  made  through  sub-com- 
mittees as  to  how  far  these  views  could  be,  and  ought  to  be, 
carried  out;  and  these  studies  have  been  submitted  for  criti- 
cism to  the  various  officers  concerned. 

The  Statutes  of  Columbia  College,  by  Section  1  of  Chapter 
III.,  authorize  the  several  Faculties  (subject  to  the  reserved 
power  of  control  by  the  Trustees  and  the  provisions  of  the 
statutes), 

"To  fix  the  requirements  of  admission,  the  course  of 
study,  and  the  conditions  of  graduation." 

5JC  8|f  >|S  *J€  *JC 


k'  To  prepare  and  publish  from  time  to  time  a  statement  of 
the  course  of  study,  specifying  the  studies  to  be  pursued  in 
each  year,  and  in  each  of  the  departments  of  instruction." 

In  Section  2  the  same  chapter  of  the  Statutes  declares 
that— 

"  No  exercise  of  the  powers  conferred  on  any  of  the 
Faculties,  which  involves  a  change  in  the  educational  policy 
of  the  College  in  respect  to  the  requirements  of  admission,  the 
course  of  study,  or  the  conditions  of  graduation,  shall  take 
effect  until  the  same  have  been  submitted  to  the  Trustees  at 
one  meeting,  and  another  meeting  shall  have  been  held  sub- 
sequent to  that  at  which  it  was  submitted." 

It  is  desirable  that  the  details  of  the  new  curriculum  should 
soon  be  published;  and  it  is  proper  and  necessary  that  first 
such  a  statement  of  it  should  be  submitted  to  the  Trustees  as 
will  comply  with  the  requirements  of  Chapter  III  ,  Section  2, 
of  the  Statutes. 

In  view  of  these  facts  your  committee  has  prepared  for 
adoption,  if  thought  best,  by  the  Faculty,  such  a  statement 
of  the  intended  curriculum,  based  on  the  orderly  collection 
of  working  details  at  hand,  as  will,  it  is  hoped,  fully  satisfy 
the  statutory  requirements,  and  form  a  basis  for  publication. 

At  the  same  time  we  have  judged  it  best,  although  the 
carefully  gathered  details  above  referred  to  are  at  hand,  not 
to  make  the  statement  too  minute,  inasmuch  as  adjustments 
will  certainly  be  called  for  as  the  successive  parts  of  the 
scheme  come  into  actual  operation. 

Such  adjustments  are  already  within  the  discretion  of  the 
Faculty. 

For  the  same  reasons,  the  publication  of  too  minute  details 
should,  in  our  judgment,  be  avoided. 

We  therefore  respectfully  recommend  to  the  Faculty  for 
adoption  the  following  statement  of  the  four-years'  course  in 
medicine,  to  be  required  of  all  who  shall  matriculate  for  the 
first  time  for  the  academic  year  1894-95,  and  thereafter. 

The  statement  expresses  the  instruction  offered  to  a  single 
student. 


FIRST   YEAR. 


PHYSICS    AND   CHEMISTRY,   INCLUDING  MEDICAL 
CHEMISTRY. 

Lectures,  four  a  week. 

Conferences,  two  a  week  for  one-half  the  year. 

Laboratory  work  in  practical  physics,  two-hour  exercise 
once  a  week,  for  one-half  the  year. 

Laboratory  work  in  practical  medical  chemistry,  two-hour 
exercises  twice  a  week,  for  one-half  the  year. 

ANATOMY,  begun. 

Demonstrations  to  sections,  four  a  week  to  each  student. 

Laboratory  work  in  dissection,  eighteen  to  twenty  hours 
a  week  for  from  three  to  five  periods  of  four  weeks  each. 

NORMAL    HISTOLOGY,   begun. 

Laboratory  work,  two-hour  exercises  three  times  a  week, 
for  one-half  the  year. 

PHYSIOLOGY,   begun. 

Lectures  combined  with  demonstrations,  three  a  week. 

Demonstrations  to  sections,  from  one  to  three  a  week  for 
each  student. 


SECOND   YEAR. 


ANATOMY,   finished. 

Lectures  combined  with  demonstrations,  three  a  week. 
Demonstrations  to  sections,  four  a  week  for  each  student 

for  one-half  the  year;  five  a  week  for  each  student  for 

one-half  the  year. 
Laboratory  work  in  dissection,  ten  to  twelve  hours  a  week 

for  from  one  to  three  periods'  of  four  weeks  each. 

NORMAL    HISTOLOGY,   finished. 

Laboratory  work,  two-hDur  exercises   twice   a   week,   for 
one-half  the  year. 

PHYSIOLOGY,   finished. 

Lectures  combined  with  demonstrations,  three  a  week. 
Demonstrations  to  sections,  from  one  to  three  a  week  for 
each  student. 

PATHOLOGICAL   ANATOMY,   begun. 

Attendance  at  autopsies,  with  practical  instruction,  twice 
a  week  for  four  weeks. 

BACTERIOLOGY. 

Laboratory  work,  two-hour  exercises  three  times  a  week, 
for  one-fourth  of  the  year. 

MATERIA   MEDICA    AND    THERAPEUTICS,   begun. 
Lectures,  three  a  week. 

TOXICOLOGY. 

Laboratory   work,   two-hour  exercises   twice  a  week,  for 
one-fourth  of  the  year. 

OBSTETRICS   AND    GYNECOLOGY,   begun. 

Recitations  combined  with   demonstrations    for  sections, 
one  a  week  for  each  student. 


THIRD   YEAR. 


MATERIA    MEDICA    AND    THERAPEUTICS,   finished. 
Lectures,  three  a  week. 

PATHOLOGICAL    ANATOMY,   finished. 

Demonstrations  to  sections,  two  a  week  for  each  student. 

PATHOLOGICAL    HISTOLOGY. 

Laboratory  work,  two-hour  exercises  three  times  a  week, 
for  one-half  the  year. 

THE  PRACTICE  OF  MEDICINE,  INCLUDING  THE 
DISEASES  OF  THE  MIND  AND  NERVOUS 
SYSTEM,  begun. 

Lectures,  three  a  week. 

Clinical  lectures  at  the  Vanderbilt  Clinic,  once  a  week. 

Clinical  lectures  or  instruction  in  the  wards  at  the  Roosevelt 
Hospital,  once  a  week ;  at  the  New  York  Hospital  once 
a  week  for  one-half  the  year;  twice  a  week  for  one-half 
the  year. 

Practical  clinical  instruction  to  sections  in  physical 
diagnosis,  for  each  student  twice  a  week  for  sixteen 
weeks. 

Practical  clinical  instruction  to  sections  in  general 
diagnosis,  for  each  student  twice  a  week  for  eight 
weeks. 

THE    PRINCIPLES    AND    PRACTICE    OF    SURGERY, 

BEGUN. 

Lectures,  three  a  week. 

Clinical  lectures  at  the  Vanderbilt  Clinic,   once  a  week. 


Clinical  lectures  and  the  witnessing  of  operations  at  the 
New  York  or  Roosevelt  Hospital,  once  a  week ;  at  the 
New  York  Hospital  (in  addition  to  the  above),  once  a 
week  for  one-half  the  year ;  at  the  Presbyterian  Hos- 
pital, once  a  week  for  one-half  the  year. 

Practical  clinical  instruction  to  sections,  for  each  student 
twice  a  week  for  sixteen  weeks. 

Optional:  Clinical  lectures  and  the  witnessing  of  opera- 
tions at  St.  Luke's  Hospital. 

OBSTETRICS  AND  GYNECOLOGY,  continued. 

Lectures,  three  a  week. 

Clinical  lectures  in  Gynecology  at  the  Vanderbilt  Clinic, 

one  a  week. 
Clinical    lectures    and    the    witnessing    of    operations    in 

Gynecology    at   the    Roosevelt   Hospital,  by  sections, 

six  exercises  for  each  student. 
Practical  clinical    instruction   to  sections  in  Gynecology, 

six  exercises  for  each  student. 

VENEREAL  DISEASES. 

Clinical  lectures  at  the  Vanderbilt  Clinic,  one  a  week. 
Clinical   lectures  at  Bellevue    Hospital,   one    a    week  for 

one-half  the  year. 
Practical  clinical  instruction  to  sections,  twelve  exercises 

for  each  student. 
Optional :  Clinics  at  the  City  Hospital,  Blackwell's  Island, 

one  a  week  for  three  months. 

DISEASES  OF  THE  EYE. 

Clinical  lectures  at  the  Vanderbilt  Clinic,  one  a  week. 
Practical  clinical  instruction  to  sections,  twelve  exercises 
for  each  student. 

DISEASES  OF  THE  EAR. 

Practical  clinical  instruction  to  sections,  six  exercises  for 
each  student. 


io 


FOURTH   YEAR. 


THE    PRACTICE    OF    MEDICINE,    INCLUDING   THE 
DISEASES     OF     THE     MIND     AND    NERVOUS 

SYSTEM,     FINISHED. 

Lectures,  three  a  week. 

Clinical  lectures  at  the  Vanderbilt  Clinic,  two  a  week. 

Clinical  lectures  or  instruction  in  the  wards,  at  the  Roose- 
velt Hospital  once  a  week ;  at  the  New  York  Hospital 
once  a  week  for  four  months. 

Practical  clinical  instruction  to  sections  in  the  wards  of 
the  Roosevelt  or  Bellevue  Hospital,  for  each  student 
two-hour  exercises,  three  times  a  week  for  eight  weeks. 

Practical  clinical  instruction  to  sections  in  the  diagnosis 
of  diseases  of  the  nervous  system,  six  exercises  for 
each  student. 

Optional :  Clinical  instruction  in  Bellevue  and  Presbyterian 
Hospitals,  once  a  week. 

CLINICAL  MICROSCOPY. 

Laboratory  work,  two-hour  exercises  twice  a  week  for 
eight  weeks. 

THE    PRINCIPLES    AND    PRACTICE    OF    SURGERY, 

FINISHED. 

Lectures,  three  a  week. 

Clinical  lecture  at  the  Vanderbilt  Clinic,  one  a  week. 

Clinical  lectures  and  the  witnessing  of  operations  at  the 
New  York  or  Roosevelt  Hospital,  once  a  week  for  one- 
half  the  year;  at  Bellevue  Hospital,  once  a  week  for 
one-half  the  year ;  at  the  Presbyterian  Hospital,  once 
a  week  for  one-half  the  year. 


Surgical  demonstrations  at  the  Roosevelt  Hospital,  once 
a  week  for  one-half  the  year. 

Practical  clinical  instruction  to  sections  in  the  wards  of 
Bellevue  Hospital,  for  each  student  two-hour  exercises 
twice  a  week  for  eight  weeks. 

Operative  surgery  on  the  Cadaver  in  sections,  twelve 
lessons ;  required  or  elective  as  may  hereafter  be 
determined. 

Optional :  Clinical  lectures  and  the  witnessing  of  operations 
at  the  New  York  Hospital  (additional  to  the  above)  at 
St.  Luke's  Hospital;  at  the  Cancer  Hospital. 

ORTHOPEDIC  SURGERY: 

Clinical  lectures  at  the  Vanderbilt  Clinic,  one  a  week. 

Practical  clinical  instruction  to  sections,  twelve  exercises 
for  each  student. 

OBSTETRICS  AND  GYNECOLOGY,   finished. 

Attendance  upon  confinements  at  the  Sloane  Maternity 
Hospital. 

Practical  clinical  instruction  in  Obstetrics  to  sections,  at 
the  Sloane  Maternity  Hospital,  for  each  student,  daily 
for  one  week. 

Clinical  lectures  in  Gynecology  at  the  Vanderbilt  Clinic, 
one  a  week. 

DISEASES  OF  CHILDREN. 

Clinical  lectures  at  the  Vanderbilt  Clinic,  one  a  week. 

Practical  clinical  instruction  to  sections,  twelve  lessons  for 
each  student. 

DISEASES  OF  THE  SKIN. 

Clinical  lectures  at  the  Vanderbilt  Clinic,  one  a  week. 

Practical  clinical  instruction  to  sections,  twelve  lessons  for 
each  student. 


12 

DISEASES  OF  THE  THROAT  AND   NOSE. 

Clinical  lectures  at  the  Vanderbilt  Clinic,  one  a  week. 

Practical  clinical  instruction  to  sections,  twelve  lessons  for 
each  student. 


ELECTIVE    COURSES. 

It  is  recommended  that  each  student  of  the  fourth  year  be 
required,  within  such  time  as  shall  be  prescribed  after  the 
beginning  of  the  academic  year,  to  elect  from  a  list  of  elective 
courses  either  one  course  or  more,  as  shall  be  determined 
hereafter;  such  election  to  be  final. 

The  course  or  courses  thus  elected,  the  student  shall  be 
required  to  attend,  and  he  shall  be  required  also  to  be  exam- 
ined thereon  at  the  end  of  the  fourth  year,  as  a  prerequisite 
for  the  degree  of  M.  D. 

It  is  recommended  that  the  elective  courses  be  numerous, 
and  in  various  departments,  both  clinical  and  otherwise;  and 
that  the  choice  be  not  confined  to  departments  represented 
in  the  Faculty  of  Medicine,  but  be  extended  to  allied  sub- 
jects. 

In  view  of  the  wide  range  of  choice  thus  to  be  provided 
for,  it  is  recommended  that  no  student  be  admitted  to  any 
elective  course  unless  his  attainments  shall  be  adjudged 
adequate  by  the  head  of  the  department  by  which  the  course 
is  offered. 

It  is   recommended  that  elective  courses  be   organized,  if 
possible,  in  the  following  themes  or  their  subdivisions,  and  in 
such  others  as  may  be  approved  hereafter: 
Surgical  Diagnosis; 
Obstetrics; 

Diagnosis  of  Nervous  Diseases; 
Localization  of  Nervous  Diseases ; 
Insanity  (clinical  course) ; 

Ophthalmology  (including  operations  at  the  Ophthalmic 
and  Aural  Institute  in  Twelfth  Street); 


*3 

Venereal  Diseases; 

Therapeutics  of  Diseases  of  the  Skin; 

Contagious  Diseases ; 

Microscopic  Technology; 

Pathologic    Anatomy   and  Histology    of  the  Organs    of 

Generation ; 
Pathologic     Anatomy    and     Histology  of   the    Nervous 

System ; 
Human  and  Comparative  Morphology  ; 
Neuro-muscular  Physiology; 
Physiological  Technique; 
Comparative  Neurology; 
Comparative  Embryology; 
Cellular  Biology; 
Morphology  of  the  Mammalia; 
Botany ; 
Philosophy ; 

Physiological  Psychology; 
Experimental  Psychology ; 
Chemistry ; 
Physics. 

It  is  recommended  that,  at  the  end  of  every  year,  each 
student  be  examined  in  the  work  of  that  year,  including,  at 
the  end  of  the  fourth  year,  his  elective  course  or  courses; 
that  the  system  of  examination  in  each  department  be  sub- 
ject, until  otherwise  ordered,  to  the  rules  at  present  in  force; 
and  that  the  result  in  each  department,  for  a  given  student, 
if  successful,  be  accounted  final  for  the  work  represented  by 
the  said  result. 

It  is  recommended  that  for  each  student  there  be  possible 
either  of  three  results  of  the  examinations  of  each  year, 
taken  collectively:  first,  that  he  proceed  with  his  class; 
second,  that  he  proceed  conditionally;  third,  that  he  do  not 
proceed  with  his  class. 

It  is  recommended  that  candidates  be  admitted  to  ad- 
vanced standing  at  the  beginning  of  the  second  or  third 
years,  but  not  of  the  fourth  year,  without  the  special  consent 


3  0112  105619743 


T4 


of  the   Faculty,  upon  satisfactory  evidence,  either  by  certifi- 
cate or  examination. 

It  is  recommended  that  no  one  be  admitted  to  advanced 
standing  in  the  new  curriculum  at  the  beginning  of  the 
second  year,  before  October,  1895;  of  the  third  year,  before 
October,  1896;  or  of  the  fourth  year,  before  October,  1897. 

It  is  recommended  that  your  Committee  be  continued,  and 
that  it  be  its  duty  immediately  to  report  to  the  Faculty  for 
adoption  a  detailed  working  scheme  for  the  first  year  of  the 
new  curriculum,  including  the  examinations  at  the  end 
thereof,  to  carry  into  effect  the  recommendations  of  the  pres- 
ent report,  provided  the  said  report  be  approved  by  the 
Trustees. 

It  is  further  recommended  that  it  be  the  duty  of  the  Com- 
mittee to  present  in  the  same  manner  a  working  scheme  for 
the  second  year,  early  in  the  academic  year  1894-95;  of  the 
third  year  early  in  1895-96;  and  of  the  fourth  year  early  in 
1896-97. 

We  have  reserved  for  the  close  of  this  report  a  brief  state- 
ment of  the  advantages  of  the  four  years'  course  hereby 
recommended,  and  which,  as  stated  earlier  in  this  report,  is 
based  upon  detailed  studies. 

The  purpose  of  the  new  curriculum  is  to  enlarge  the  oppor- 
tunities for  instruction  in  medicine,  and  especially  to 
strengthen  object  teaching  in  medicine  regarded  as  essentially 
a  department  of  physical  science,  theoretical  and  applied. 

In  departments  which  teach  largely  or  wholly  by  demon- 
strations, by  laboratory  exercises,  or  by  both,  a  greater  range 
and  thoroughness  are  secured  for  the  themes  now  taught,  and 
time  is  found  for  courses  practically  or  absolutely  new,  such 
as  practical  physics,  practical  toxicology,  practical  bacteri- 
ology and  clinical  microscopy. 

In  advanced  themes  where  demonstration  and  practical 
work  take  the  form  of  clinical  exercises  for  larger  or  smaller 
divisions  of  the  classes,  the  same  holds  good ;  various  new 
courses  at  hospitals  or  at  the  Vanderbilt  Clinic  being  created ; 
existing  courses  being  much  strengthened,  or  lifted  from  their 
present  plane  as  purely  optional  courses  to  be  part  of  the 


